Provider Demographics
NPI:1033449699
Name:AGU, ODINAKACHUKWU
Entity Type:Individual
Prefix:
First Name:ODINAKACHUKWU
Middle Name:
Last Name:AGU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5103 SAXON HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-7577
Mailing Address - Country:US
Mailing Address - Phone:832-305-1725
Mailing Address - Fax:713-673-0432
Practice Address - Street 1:4315 LOCKWOOD DR
Practice Address - Street 2:SUITE #7
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77026-4117
Practice Address - Country:US
Practice Address - Phone:832-305-1725
Practice Address - Fax:713-673-0432
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker